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Race and resource allocation: an online survey of US and UK adults' attitudes toward COVID-19 ventilator and vaccine distribution.
Kappes, Andreas; Zohny, Hazem; Savulescu, Julian; Singh, Ilina; Sinnott-Armstrong, Walter; Wilkinson, Dominic.
  • Kappes A; Psychology, City University of London, London, UK.
  • Zohny H; Oxford Uehiro Centre for Practical Ethics, Univeristy of Oxford, Oxford, UK Hazem.zohny@philosophy.ox.ac.uk.
  • Savulescu J; Oxford Uehiro Centre for Practical Ethics, Univeristy of Oxford, Oxford, UK.
  • Singh I; Centre for Biomedical Ethics, National University of Singapore, Singapore.
  • Sinnott-Armstrong W; Psychiatry, University of Oxford, Oxford, UK.
  • Wilkinson D; Philosophy, Duke University, Durham, North Carolina, USA.
BMJ Open ; 12(11): e062561, 2022 11 21.
Article in English | MEDLINE | ID: covidwho-2137738
ABSTRACT

OBJECTIVE:

This study aimed to assess US/UK adults' attitudes towards COVID-19 ventilator and vaccine allocation.

DESIGN:

Online survey including US and UK adults, sampled to be representative for sex, age, race, household income and employment. A total of 2580 participated (women=1289, age range=18 to 85 years, Black American=114, BAME=138).

INTERVENTIONS:

Participants were asked to allocate ventilators or vaccines in scenarios involving individuals or groups with different medical risk and additional risk factors.

RESULTS:

Participant race did not impact vaccine or ventilator allocation decisions in the USA, but did impact ventilator allocation attitudes in the UK (F(4,602)=6.95, p<0.001). When a racial minority or white patient had identical chances of survival, 14.8% allocated a ventilator to the minority patient (UK BAME

participants:

24.4%) and 68.9% chose to toss a coin. When the racial minority patient had a 10% lower chance of survival, 12.4% participants allocated them the ventilator (UK BAME

participants:

22.1%). For patients with identical risk of severe COVID-19, 43.6% allocated a vaccine to a minority patient, 7.2% chose a white patient and 49.2% chose a coin toss. When the racial minority patient had a 10% lower risk of severe COVID-19, 23.7% participants allocated the vaccine to the minority patient. Similar results were seen for obesity or male sex as additional risk factors. In both countries, responses on the Modern Racism Scale were strongly associated with attitudes toward race-based ventilator and vaccine allocations (p<0.0001).

CONCLUSIONS:

Although living in countries with high racial inequality during a pandemic, most US and UK adults in our survey allocated ventilators and vaccines preferentially to those with the highest chance of survival or highest chance of severe illness. Race of recipient led to vaccine prioritisation in cases where risk of illness was similar.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccines / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2022-062561

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccines / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2022-062561